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One Health and many hands. PUM at the table during the state visit to India
In October 2019 Antimicrobial Resistance specialist Bartelt de Jongh joined the state visit of the Dutch Royal couple and the trade mission to India on behalf of PUM. Antimicrobial resistance (AMR) was high on the agenda during the whole week.
When it comes to antimicrobial resistance, looking at India means to look at one scenario that might be our global future: Studies say that roughly 70% of the Indian population carry an antimicrobial resistance already. Resistant bacteria are everywhere: via animals, especially in the livestock sector, who are being given antibiotics out of habit rather than real necessity, they find their way into the food chain; due to common practice of antibiotics producers to discharge their waste into rivers, they end up in plants (including fruit and vegetables) and in the water supply. And the result: Within just 75 years since the second world war, we are witnessing a complete escalation of antimicrobial resistance, to the extent that antibiotics become less and less effective. In India simple injuries cause infections, which lead to a series of complications already today – soon we might be in the same situation all over the world, losing millions of lives to antimicrobial resistance. It is a rather grim scenario for a global future, Bartelt calls it “an uncomfortable prospect”, stressing that we are not as distant from it as we would like to be.
Discussing AMR at the round table
All ministries involved in the state visit and the trade mission (from medical care and economic affairs to agriculture and foreign affairs) agreed to put antimicrobial resistance high on the agenda. Throughout the week, meetings, discussions and various activities on the topic were organised. The round table chaired by the Dutch minister for Medical Care, Bruno Bruins, was one of the high points.
"A state visit like this brings together so many different parties – exactly what is needed for AMR, which transcends the various departments."
Participants from various relevant disciplines and from both countries prepared and discussed a series of statements, be it questions of research and innovation or prevention in the form of disinfection or vaccination and many more. “A state visit like this brings together so many different parties – exactly what is needed for tackling antimicrobial resistance, which transcends the various departments … and it was great to see how PUM can have a central role in the combined effort to solve this issue”, Bartelt says. “PUM has 1700 experts in the most diverse disciplines. You will always find an expert with the necessary knowledge who is available and ready to be deployed wherever needed.” In short: PUM – like minister Bruin’s round table – basically is One Health in action, combining representatives of the relevant sectors in one spot. Together we can shape the smart policy we need and start to make a difference.
Looking for a shared narrative
Is it possible to talk business, namely trade, on such a serious topic? You could argue that it is not only possible, but also necessary. After all in the case of antimicrobial resistance the rules of the game have completely changed and the pharmaceutical industry needs to reconsider its business model from scratch. Antibiotics belong to the products you actually don’t want to sell. The focus needs to be to sell as little as possible. This is just one of the many challenges ahead. “It all starts with a shared narrative”, Bartelt says: “The farmer who administers antibiotics to his livestock needs to understand as well that one of the effects of his action might very well be that he cannot be treated properly when he goes into hospital a few months later …”
Looking back at the experience, Bartelt summarises: “My role is to share knowledge. As a microbiologist I am an expert, but in the context of the trade mission I mainly acted as a sounding board and bridge builder across the themes.” He describes an excursion to the hospital of Bangalore, its state-of-the-art equipment, its perfect organisation.
“The farmer who administers antibiotics to his livestock needs to understand that one of the effects of his action might very well be that he cannot be treated properly when he goes into hospital a few months later …”
“The scale of everything in India is remarkable: In this hospital they conduct 20.000 heart operations every year - the biggest heart hospital in the Netherlands does around 2.000! They are confronted with serious cases of antimicrobial resistance every day. Yet everyone I spoke to was very open and eager to learn and improve. And in turn we can learn from them as well, think for instance of IT ...” Asked about concrete results of the week in India, Bartelt waves in the air a big stack of business cards: endlessly many contacts to follow up with, amongst others with WHO Director of India; and it was nice to discover that PUM has made a name for itself already: “PUM is well known within the various Dutch ministries … and also the former Dutch Ambassador was well impressed. The impact of our work is bigger than we think.”
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Text: Sylvia Szely
Photo: Rahul Shah and Kaboompics.com (Pexels)